Hydrocortisone butyrate for severe inflammatory skin conditions
Locoid
Peer reviewed by Sid DajaniLast updated by Michael Stewart, MRPharmSLast updated 5 May 2024
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You only need to use a small amount of this preparation. Apply it thinly just to the areas affected, and then massage it gently into the skin until it disappears.
Topical corticosteroids should not be used for long periods of time or on large areas of the body, especially in children. As a general guide, corticosteroids should not be used continuously for more than 5 days in children and 7 days in adults, unless your doctor gives specific instructions to do so.
Do not use the preparation on any infected areas of skin.
In this article:
About hydrocortisone butyrate
Type of medicine | A potent topical corticosteroid |
Used for | Inflammatory skin conditions such as severe eczema and dermatitis |
Also called | Locoid® |
Available as | Cream, ointment, lotion (called a topical emulsion) and scalp lotion |
Hydrocortisone butyrate is classed as a potent topical corticosteroid. Topical corticosteroids are also referred to as topical steroids. Topical steroids are used in addition to moisturisers (emollients) for treating inflammatory skin conditions such as eczema and dermatitis. A topical steroid is used when patches of eczema or dermatitis flare up. Hydrocortisone butyrate relieves the symptoms of a flare-up by reducing inflammation, itching and redness. It is not a cure for the condition, but it will help to relieve the symptoms. Short courses of hydrocortisone butyrate may also be prescribed for the treatment of psoriasis for small areas such as the scalp, soles of the feet, or palms of the hands.
Hydrocortisone butyrate is available in a number of different preparations. It is likely you will be prescribed a cream if the affected areas of your skin are moist or weeping, an ointment if your skin is dry, or a lotion for larger or hairy areas of skin. It is also available as an application for the scalp. Hydrocortisone butyrate is not generally suitable for children, although short courses of up to two weeks may occasionally be prescribed for a child by a skin specialist doctor.
It is important that you do not confuse hydrocortisone butyrate preparations with creams and ointments simply called 'hydrocortisone'. These are milder topical steroid preparations and can be bought from pharmacies. Hydrocortisone butyrate is a much more potent steroid and is only available on prescription. There is more information about the milder preparations in a leaflet called Hydrocortisone for mild inflammatory skin conditions.
Before using hydrocortisone butyrate
To make sure this is the right treatment for you, before you start using hydrocortisone butyrate it is important that your doctor knows:
If you have any areas of infected skin.
If you have rosacea or acne.
If you are pregnant or breastfeeding.
If you have ever had an allergic reaction to a skin preparation.
Continue reading below
How to use hydrocortisone butyrate
Before you start using the preparation, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about topical steroids and will provide you with a full list of the side-effects that you may experience from using them.
Apply a small amount to the areas of skin which are inflamed. Then gently rub it into the skin until it has disappeared. If you are using a scalp application, apply it to the affected area of scalp, rub it in gently, and then allow the area to dry again naturally.
Do not use hydrocortisone butyrate on any open sores or areas of infected skin.
The amount of topical steroid that you should apply is commonly measured by fingertip units (FTUs). One FTU is the amount of cream or ointment that is squeezed out along an adult's fingertip (that is, from the very end of the finger to the first crease in the finger). As a guide, one FTU is enough to cover an area twice the size of an adult hand. Your doctor will give you an idea of how many FTUs you will need to cover the area of your skin which is affected.
Your doctor will tell you how often to apply hydrocortisone butyrate. It should not be applied more than twice a day, and once a day is often sufficient.
If you are using more than one topical corticosteroid, make sure you know when and where to use each one. If you are unsure, check with your doctor or ask your pharmacist for further advice.
After you have applied hydrocortisone butyrate, remember to wash your hands (unless your hands are the treated area).
If you are using hydrocortisone butyrate for psoriasis, make sure you follow your doctor's instructions carefully. It should not be used for large areas of psoriasis or for long periods of time, as these can cause your symptoms to flare up again afterwards.
Getting the most from your treatment
If you are using a moisturiser along with this preparation, apply the moisturiser first. Then wait 10-15 minutes before applying hydrocortisone butyrate. This allows time for the moisturiser to be absorbed before the topical corticosteroid is applied. Your skin should be moist but not slippery when you apply hydrocortisone butyrate.
Do not use hydrocortisone butyrate on your face unless a skin specialist doctor has said you should. If you have been told to use it on your face, be careful not to get any preparation near your eyes and do not use it for longer periods of time than you have been advised.
Unless advised to do so by your doctor, do not apply a bandage or dressing to the area being treated, as this will increase absorption of the preparation and increase the risk of side-effects.
Continue to use hydrocortisone butyrate until the flare-up has gone, and then stop it. A course of treatment for 7-14 days is often sufficient. If your symptoms have not improved after this time (or if they get worse), speak again with your doctor for further advice. Topical corticosteroids like hydrocortisone butyrate should not be used for long periods of time or on large areas of the body.
After you finish using hydrocortisone butyrate, continue to use your moisturiser every day. This will help to prevent a further flare-up. Your doctor may also prescribe a less potent steroid cream for you to use when needed.
Continue reading below
Can hydrocortisone butyrate cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. You can reduce the risk of side-effects from hydrocortisone butyrate, by applying the preparation thinly, no more than twice a day, and to the affected areas only.
Side-effects of hydrocortisone butyrate skin preparations | What can I do if I experience this? |
Burning or stinging feeling | These may occur in the first few days but usually get better after this |
Thinning of the skin, permanent stretch marks, allergic contact dermatitis, acne, rosacea, and hair growth at the site of application | These would normally only affect you if you use hydrocortisone butyrate for long periods of time |
Hydrocortisone butyrate may get through your skin and into your bloodstream | This usually causes no problem unless you use hydrocortisone butyrate regularly on large areas of your skin |
Important: continuous or prolonged use of corticosteroid skin preparations is not recommended. As a general guide, corticosteroids should not be used continuously for more than 5 days in children and 7 days in adults, unless your doctor gives specific instructions to do so. This is to prevent the risk of more serious side-effects with prolonged use. In addition, prolonged use can lead to more severe flare-ups of your skin condition when you do stop treatment. Always continue to moisturise your skin after stopping treatment with any corticosteroid preparation. If you experience severe redness, burning or stinging of your skin within a few days or weeks of stopping treatment you should consider over-use of the corticosteroid as a possible cause. Speak to your doctor or a pharmacist for advice in this case.
Important: there is a risk of fire when creams and ointments are absorbed by fabrics (such as clothing or bedsheets), making them flammable. A spark or flame can easily ignite the fabric. The risk is highest when large amounts of paraffin-based products are applied and absorb into fabrics. However, there is also a risk when non-paraffin products are used. Be aware of this fire hazard when repeatedly using large amounts of any skin product. Do not smoke or go near naked flames.
When used as directed by your doctor or pharmacist, steroid creams will be applied in small quantities on small areas of skin. There should be minimal absorption into fabrics and a lower risk of fire.
Speak with your doctor or pharmacist for further advice if you experience any other side-effects which you think may be due to hydrocortisone butyrate.
How to store hydrocortisone butyrate
Keep all medicines out of the reach and sight of children.
Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Important information about all medicines
Make sure that the person prescribing this medicine knows about any other medicines that you are taking or using. This includes medicines you buy and herbal and homeopathic medicines.
Before using this medicine tell your doctor if you have ever had an allergic reaction after taking or using any medicine.
Never use more than the prescribed dose. If you suspect that someone has swallowed some of the medicine by accident, contact the accident and emergency department of your local hospital for advice.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking or using.
If you buy any medicines check with a pharmacist that they are safe to take with your other medicines.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Report side effects to a medicine or vaccine
If you experience side effects, you can report them online through the Yellow Card website.
Further reading and references
- Manufacturer's PIL, Locoid® Cream; Neon Healthcare Ltd, The electronic Medicines Compendium. Dated November 2023.
- Medicines Complete BNF 87th Edition; British Medical Association and Royal Pharmaceutical Society of Great Britain, London.
Article history
The information on this page is written and peer reviewed by qualified clinicians.
Next review due: 9 Mar 2027
5 May 2024 | Latest version
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